Added value of technician intervention to improve mask management for apneic patients treated with long-term CPAP.

IF 2 4区医学 Q3 CLINICAL NEUROLOGY Sleep and Breathing Pub Date : 2025-02-28 DOI:10.1007/s11325-025-03279-2

Celia Vidal, Fanny Bertelli, Jean-Pierre Mallet, Raphael Gilson, Jean-Christian Borel, Frédéric Gagnadoux, Sarah Skinner, Arnaud Bourdin, Nicolas Molinari, Dany Jaffuel

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Abstract

Purpose: Long-term management of sleep apnea patients treated with CPAP raises questions about the cost-effectiveness of certain resources. With the growing use of remote CPAP monitoring and patient questionnaires, the importance of direct patient supervision by technicians is being challenged. To date, no real-life study has investigated the long-term additional value of a technician in evaluating common CPAP side effects compared to patient-reported side effects.

Methods: InterfaceVent-CPAP is a prospective real-life cross-sectional study conducted in a cohort of apneic adults treated with CPAP for at least 3 months. Three common CPAP side effects (pain, erythema, and leaks) were independently assessed by the patient and the technician on visual analogue scales and diagrams, respectively. CPAP-reported leaks were also collected. Gwet's concordance coefficient was used to analyze concordance between patient and technician assessments of CPAP side effects.

Results: 1484 patients (median age 67 years (IQ_25-75: 60-74)) were evaluated by 32 technicians. Correlation between CPAP-reported leaks and technician-reported leaks was weak. For pain and erythema, moderate to high concordance was observed between technician and patient responses, while no concordance was found for leaks. Univariate linear regression analyses examining the effect of technician-reported areas of pain, erythema and leaks on the Epworth-Sleepiness-Scale revealed statistically significant associations between sleepiness in women and certain technician-reported areas of mask leaks and mask pain.

Conclusion: Direct supervision of chronic apneic patients by technicians adds value in managing mask-related issues. Long-term care should include a combination of remote CPAP monitoring, patient-reported outcomes, and technician direct supervision.

Trial registration: InterfaceVent is registered with ClinicalTrials.gov (NCT03013283). First registration date is 2016-12-23.

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技术干预对长期CPAP治疗的呼吸暂停患者面罩管理的提高价值。

目的：使用CPAP治疗的睡眠呼吸暂停患者的长期管理提出了某些资源的成本效益问题。随着越来越多地使用远程CPAP监测和患者问卷调查，由技术人员直接监督患者的重要性正在受到挑战。到目前为止，还没有真实的研究调查了技术人员在评估常见CPAP副作用和患者报告的副作用方面的长期附加价值。方法：InterfaceVent-CPAP是一项前瞻性现实横断面研究，在接受CPAP治疗至少3个月的呼吸暂停成人队列中进行。三种常见的CPAP副作用（疼痛、红斑和渗漏）分别由患者和技术人员在视觉模拟量表和图表上独立评估。cpap报告的泄漏也被收集。采用Gwet的一致性系数来分析患者和技术人员对CPAP副作用评估的一致性。结果：32名技术人员对1484例患者（中位年龄67岁（IQ25-75: 60-74））进行了评估。cpap报告的泄漏与技术人员报告的泄漏之间的相关性较弱。对于疼痛和红斑，在技术人员和患者的反应中观察到中度到高度的一致性，而对于泄漏没有发现一致性。单变量线性回归分析检验了技术人员报告的疼痛区域、红斑和渗漏对艾普沃斯-嗜睡量表的影响，结果显示，女性的嗜睡与技术人员报告的某些口罩渗漏区域和口罩疼痛之间存在统计学上的显著关联。结论：技术人员对慢性呼吸暂停患者进行直接监护，有助于管理口罩相关问题。长期护理应包括远程CPAP监测、患者报告的结果和技术人员直接监督的组合。试验注册：InterfaceVent已在ClinicalTrials.gov注册（NCT03013283）。首次注册日期为2016-12-23。

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来源期刊

Sleep and Breathing 医学-呼吸系统

CiteScore

5.20

自引率

4.00%

发文量

222

审稿时长

3-8 weeks

期刊介绍： The journal Sleep and Breathing aims to reflect the state of the art in the international science and practice of sleep medicine. The journal is based on the recognition that management of sleep disorders requires a multi-disciplinary approach and diverse perspectives. The initial focus of Sleep and Breathing is on timely and original studies that collect, intervene, or otherwise inform all clinicians and scientists in medicine, dentistry and oral surgery, otolaryngology, and epidemiology on the management of the upper airway during sleep. Furthermore, Sleep and Breathing endeavors to bring readers cutting edge information about all evolving aspects of common sleep disorders or disruptions, such as insomnia and shift work. The journal includes not only patient studies, but also studies that emphasize the principles of physiology and pathophysiology or illustrate potentially novel approaches to diagnosis and treatment. In addition, the journal features articles that describe patient-oriented and cost-benefit health outcomes research. Thus, with peer review by an international Editorial Board and prompt English-language publication, Sleep and Breathing provides rapid dissemination of clinical and clinically related scientific information. But it also does more: it is dedicated to making the most important developments in sleep disordered breathing easily accessible to clinicians who are treating sleep apnea by presenting well-chosen, well-written, and highly organized information that is useful for patient care.